Jessica Rose Blazivic

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

CM60369054 Issued in WA

Practice address

3919 N Maple St
Spokane, WA 99205-1349

Phone

(509) 444-8200

Fax

(509) 444-7806

NPI assigned

Dec 19, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1376059964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N WASHINGTON ST STE 300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010254",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 N MAPLE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051349",
            "telephone_number": "509-444-8200",
            "fax_number": "509-444-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZIVIC",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WA",
            "license": "CM60369054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morrie M Bland, CD
• Natalie Lynn Blashill, LMP
• Samantha Gaetana-Nania Blatner
• Gwyneth Blattau, MD
• Erin Blau, DNP, MPH, FNP-BC
• John William Bleakmore
• Michelle Marie Bleek
• Allison Blehm, RN
• Blessedhouse Afh
• Blessedhouse Howard Afh LLC

• Community Health Worker in Spokane, WA
• Providers in Spokane, WA by specialty
• Community Health Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.